Take home substitution maintenance therapy up to 14 days

There is a good saying: With any luck it will be a disgrace! This is exactly the sort of case when such fantastic changes in the SMT provision can occur not even ‘due to’ , like it happens in Ukraine, where before the quarantine every second patient received take home dosages, and now almost all of them do, but also ‘despite of’ how it happened in other countries of the region, where take home SMT was just a dream before.
Anton Basenko PITCH Program Manager, ICF Allience for Public Health

Task

Quarantine restrictions, namely the impossibility of free travels and the inability to use public transport, the risks of infection due to crowds in the OST sites and low immune status, created obstacles for patients of substitution maintenance therapy programs to receive medication and, therefore, to continue treatment. This could lead to interruption of treatment, the loss of patients from the program and, thus, the efforts of many participants could be made over in the process in vain, from local initiative groups and non-governmental organizations to large international donors of financial resources, to implement these programs and return to a high number of people who use drugs and, consequently, the potential worsening of the situation with the AIDS epidemic in Ukraine.

Solution

After the announcement of quarantine and the outbreak of the coronavirus epidemic, SMT began to be provided on take-home basis in some countries of the EECA region for a period from 5 to 14 days, in Ukraine this period is up to 14 days, in most cases 10 days.

Within the framework of the project with the support of the Global Fund, the International Technical Assistance Project ‘Improving the Quality and Sustainability of Sunstitution Maintainance Treatment in Ukraine’, which is being implemented with financial support from the US Centers for Disease Control and Prevention (CDC), it has become possible to provide  patients with take-home OST for up to 14 days. Within the framework of the project, one of the most important conditions for the rapid transition of OST patients to a 10-day form of medication delivery was provided – more than 50,000 quick tests for determining psychoactive substances (surfactants) were delivered. This initiative was also accompanied by a request to law enforcement agencies regarding the prevention of violations of the rights of patients with OST who are transferred to the self-taking of narcotic drugs OST for a quarantine period of up to 10 days.

In addition to issuing medication for a longer period for taking them at home, the quarantine SMT program also supports its patients with online counseling by phone using Skype, Viber, Telegram services, escorting clients to health care facilities as necessary, optimizing the work schedule SMT sites for convenient distribution of customer flows and additional counseling regarding the prevention of COVID-19.

Result

Currently, almost 90% of patients in substitution maintenance therapy in Ukraine receive take-home medications for a period of 10 days.